Nick Georgiadis

Long-term follow up of autologous serum treatment for recurrent corneal erosions.

Purpose:  The aim of the study was to evaluate long‐term results of autologous serum treatment for recurrent corneal erosions.

EPIPHORA CAUSED BY CONJUNCTIVOCHALASIS: TREATMENT WITH TRANSPLANTATION OF PRESERVED HUMAN AMNIOTIC MEMBRANE

Purpose. To present our experience with the use of preserved human amniotic membrane on patients with epiphora caused by conjunctivochalasis. Methods. Twelve patients, seven women and five men, ages ranging from 56 to 72 years (mean, 61 years) were referred to our Cornea Service with chronic epiphora. In all patients, no punctal ectropion was present, the lacrimal pathway was patent, and the dye disappearance test was abnormal. All patients had already undergone various therapies including multiple irrigations of the lacrimal system, antibiotic drops, steroid drops, and artificial tear drops. In all patients, conjunctivochalasis, which was not previously diagnosed, was evident on slit-lamp examination. After surgical removal of the excess conjunctiva, preserved human amniotic membrane was placed over and sutured with 10-0 nylon continuous suture to the free conjunctival edges. During the postoperative period, artificial tear drops and steroid/antibiotic drops were applied. Results. Improvement of the epiphora was evident from the first postoperative day. After removal of the suture 10 to 15 days (mean, 12 days) after surgery, no patient complained of epiphora. The dye disappearance test was normal. During the follow-up period, which ranged from 6 to 11 months (mean, 8 months), no patient complained of epiphora and no conjunctivochalasis was detected in the area in which human amniotic membrane was transplanted. Conclusion. In our experience, transplantation of preserved human amniotic membrane greatly improved symptoms of epiphora caused by conjunctivochalasis. Continued education of the general ophthalmologists concerning this condition is required.

Cryopreserved amniotic membrane transplantation for the management of symptomatic bullous keratopathy.

Background:  To report the results of cryopreserved human amniotic membrane transplantation for the management of symptomatic bullous keratopathy.

Endogenous group G Streptococcus endophthalmitis following a dental procedure

Purpose To report a case of bilateral endogenous endophthalmitis due to group G Streptococcus after a dental procedure. METHODS Case report of a 69-year-old woman who presented with pain, decreased vision, bilateral uveitis, and a unilateral hypopyon 1 week after treatment for an abscessed tooth. Results Bilateral endophthalmitis was diagnosed, and group G Streptococcus was cultured from the vitreous samples. CONCLUSIONS To our knowledge, this is the second reported case of endogenous endophthalmitis following a dental procedure. Furthermore, it was due to group G Streptococcus, which is a rare cause of this condition.

Coralline hydroxyapatite sphere in orbit restoration.

Purpose To restore the anophthalmic socket, primarily or secondarily, using a hydroxy-apatite sphere (HA). Methods We used HA in 33 patients (25 male, 8 female), aged from 4 to 68 years (mean 38.1 years) for 19 primary and 14 secondary implantations. HA spheres measured 16 mm in one patient, 18 mm in 21 and 20 mm in 11. The spheres were wrapped in donor sclera preserved in absolute alcohol. All six extraocular muscles were isolated, in the cases where this was possible. Buccal membrane was grafted in three patients to restore the fornices. Drilling was done on four patients using a 3.8 serrated plastic sheath. Results During follow-up of 7 - 69 months we observed no complications except for slight edema in the immediate postoperative period. All patients gained very good to excellent motility of the implant, acceptable symmetric appearance in the case of primary implantation, and a dramatic improvement of facial appearance in the case of secondary implantation. Conclusions HA spheres are an excellent orbital implant for primary and secondary restoration of the anophthalmic socket causing no serious complications

Low-dose tissue plasminogen activator in the management of anterior chamber fibrin formation

Purpose: To investigate the efficacy of tissue plasminogen activator (tPA) in the treatment of severe fibrinous anterior chamber reactions after intraocular surgery. Setting: Ophthalmology Department, AHEPA University Hospital, Thessaloniki, Greece. Methods: The study comprised routine surgical and postoperative cases selected in a nonrandomized fashion. Low‐dose tPA infusion (0.2 mL of 125 &mgr;g/mL) was administered through a side‐port in the anterior chamber in 25 patients with recent or long‐standing fibrin formation after cataract extraction (n = 13), trabeculectomy (n = 5), combined procedure (n = 5), or penetrating keratoplasty (n = 2). Patients were treated 4 to 25 days postoperatively (mean 7 days). Results: Fibrin lysis was observed 2 to 12 hours after tPA infusion. No hemorrhage or other complications occurred, and no further treatment was necessary in any patient. Three cases of delayed partial fibrin lysis resolved with intense topical steroid treatment. There were no recurrences over the 3‐month follow‐up. Conclusions: Low‐dose tPA was an effective and safe method for the management of anterior chamber fibrin formation. Treatment was well tolerated and gave excellent results with no complications.

A Simple Ocular Irrigation System for Alkaline Burns of the Eye

An alkaline burn of the eye constitutes an ocular emergency. Emergency treatment consisting of copious irrigation begins at the site of the accident and alters the outcome of the injury. The authors describe a low-cost, simple, and effective system for continuous irrigation of the ocular surface after a severe alkaline burn of the eye. This system also can be applied by inexperienced personnel during the transport of a patient to an ophthalmologic center.

Combination of periocular myocutaneous flaps for one-stage reconstruction of extensive defects of the eyelid.

We present the reconstructive challenge after excision of a large periocular tumour in a patient who needed early visual rehabilitation. The periocular full thickness deficit of his only sighted eye was reconstructed with a combination of periocular myocutaneous flaps and a free buccal mucosal graft. Adequate functional and cosmetic results with early visual rehabilitation were achieved in a single procedure.